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Open Access 01-12-2008 | Research
Changes in the total leukocyte and platelet counts in Papuan and non Papuan adults from northeast Papua infected with acute Plasmodium vivax or uncomplicated Plasmodium falciparum malaria
Published in: Malaria Journal | Issue 1/2008
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Background
There are limited data on the evolution of the leukocyte and platelet counts in malaria patients.
Methods
In a clinical trial of chloroquine vs. chloroquine plus doxycycline vs. doxycycline alone against Plasmodium vivax (n = 64) or Plasmodium falciparum (n = 98) malaria, the total white cell (WCC) and platelet (PLT) counts were measured on Days 0, 3, 7 and 28 in 57 indigenous Papuans with life long malaria exposure and 105 non Papuan immigrants from other parts of Indonesia with limited malaria exposure.
Results
The mean Day 0 WCC (n = 152) was 6.492 (range 2.1–13.4) × 109/L and was significantly lower in the Papuans compared to the non Papuans: 5.77 × 109/L vs. 6.86 × 109/L, difference = -1.09 [(95% CI -0.42 to -1.79 × 109/L), P = 0.0018]. 14 (9.2%) and 9 (5.9%) patients had leukopaenia (<4.0 × 109/L) and leukocytosis (>10.0 × 109/L), respectively. By Day 28, the mean WCC increased significantly (P = 0.0003) from 6.37 to 7.47 × 109/L (73 paired values) and was similar between the two groups. Ethnicity was the only WCC explanatory factor and only on Day 0.
The mean Day 0 platelet count (n = 151) was 113.0 (range 8.0–313.0) × 109/L and rose significantly to 186.308 × 109/L by Day 28 (P < 0.0001). There was a corresponding fall in patient proportions with thrombocytopaenia (<150 × 109/L): 119/151 (78.81%) vs. 16/73 (21.92%, P < 0.00001). Papuan and non Papuan mean platelet counts were similar at all time points. Only malaria species on Day 0 was a significant platelet count explanatory factor. The mean D0 platelet counts were significantly lower (P = 0.025) in vivax (102.022 × 109/L) vs. falciparum (122.125 × 109/L) patients.
Conclusion
Changes in leukocytes and platelets were consistent with other malaria studies. The Papuan non Papuan difference in the mean Day 0 WCC was small but might be related to the difference in malaria exposure.